Feasibility of a dual microcatheter-dual interlocking detachable coil technique in preoperative embolization in preparation for distal pancreatectomy with en bloc celiac axis resection for locally advanced pancreatic body cancer

• Published in: Journal of hepato-biliary-pancreatic sciences 2012-07, Vol.19 (4), p.431-437
• Main Authors: Abo, Daisuke, Hasegawa, Yu, Sakuhara, Yusuke, Terae, Satoshi, Shimizu, Tadashi, Tha, Khin Khin, Tanaka, Eiichi, Hirano, Satoshi, Kondo, Satoshi, Shirato, Hiroki
• Format: Article
• Language: English
• Subjects: Abdominal Surgery; Aged; Aged, 80 and over; Cancer; Catheterization, Peripheral - methods; Catheters; Collateral Circulation; embolization; Embolization, Therapeutic - instrumentation; Embolization, Therapeutic - methods; Equipment Design; Feasibility Studies; Female; Gastroenterology; Hepatic Artery; Hepatology; Humans; interlocking detachable coil; Male; Medicine; Medicine & Public Health; microcatheter; Middle Aged; Original Article; Pancreatectomy; pancreatic cancer; Pancreatic Neoplasms - surgery; Preoperative Period; Surgical Oncology
• ISSN: 1868-6974; 1868-6982
• DOI: 10.1007/s00534-011-0455-9

Purpose To describe the feasibility of a dual microcatheter-dual interlocking detachable coil (DMDI) technique for preoperative embolization of the common hepatic artery (CHA) in preparation for distal pancreatectomy with en bloc celiac axis resection (DP-CAR) for locally advanced pancreatic body cancer. Methods From January 2007 to December 2009, 26 patients underwent embolization of the CHA by the DMDI technique. We compared the results with those of 37 patients in whom the CHA was embolized by conventional techniques from August 1998 to February 2007. Results With the DMDI technique, no coil migration or other embolization-related complications occurred. The success rate was 100%. The rate of embolization-related complications was significantly lower in the DMDI embolization group (0%) than in the conventional embolization group (24.3%) ( P  = 0.008). The frequency of improper positioning of the embolic material necessitating its removal during DP-CAR was significantly lower in the DMDI embolization group (10%) than in the conventional embolization group (37.5%) ( P  = 0.044). Conclusion The DMDI technique allows the development of collateral pathways, reduces the surgeon's burden in ligating the distal CHA, and prevents coil migration. For these reasons, we believe that this technique is feasible for embolization of the CHA in preparation for DP-CAR for locally advanced pancreatic body cancer.